Individual
S. BERNARD BAGLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
148 GEORGIA AVE E STE C, FAYETTEVILLE, GA 30214-1616
(404) 968-4662
(404) 968-4562
Mailing address
375 WINDERMERE CIR, NEWNAN, GA 30265-2278
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW007300
GA
Other
Enumeration date
12/18/2018
Last updated
05/16/2022
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